术后持续腰大池引流治疗重型颅脑损伤合并蛛网膜下腔出血

Continuous lumbar cistern drainage after craniotomy for severe traumatic brain injury with subarachnoid hemorrhage

目的探讨术后持续腰大池引流对重型颅脑损伤合并蛛网膜下腔出血(tSAH)的治疗效果。方法将60例重型颅脑损伤合并tSAH的患者于开颅术后随机分为两组,治疗组30例,行持续腰大池引流术引流脑脊液;对照组30例,行多次腰椎穿刺术放脑脊液;对两组治疗方法的效果进行评价。结果治疗组GCS评分、脑脊液红细胞计数检测、蛛网膜下腔积血清除时间、并发症的发生率及疗效预后均优于对照组。结论重型颅脑损伤合并蛛网膜下腔出血术后早期行腰大池持续外引流能清除血性脑脊液,减少并发症,改善预后。

Objective To study the effects of continuous lumbar cistern drainage after craniotomy in severe craniocerebral injury with subaraehnoid hemorrhage （tSAH）. Methods 60 patients with severe craniocerebral injury with tSAH in postoperative craniotomy were divided into treatment group and control group. 30 patients in treatment group were underwent by lines of continued lumbar cerebrospinal fluid drainage drainage pool. 30 patients in control group were underwent by multiple lumbar puncture cerebrospinal fluid. The effects of two groups of treatment evaluation were summarized. Results GCS score of the treatment group, cerebrospinal fluid red blood cell count, subarachnoid hemorrhage clearing time the incidence of complications and prognosis of curative effect are better than that of control group. Conclusions Severe craniocerehral injury with subarachnoid hemorrhage in a large line early postoperative lumbar pool can remove hemorrhagic cerebrospinal fluid drainage,reduce the complications and improve the prognosis.